| NPI | 1811448954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BUZA Medical Assistant 321-676-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL OS6304) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS6304) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |